HEALTH EDUCATION THAMES VALLEY - SPECIALTY
TRAINING PROGRAMME IN EMERGENCY MEDICINE
About Health Education Thames Valley
We are the Local Education and Training Board (LETB) for Thames Valley covering
Berkshire, Buckinghamshire and Oxfordshire. Our vision is to ensure the delivery of
effective workforce planning and excellent education and training to develop a highly
capable, flexible and motivated workforce that delivers improvements in health for
the population of Thames Valley. Thames Valley LETB is responsible for the training
of some 1500 trainees
Health Education Thames Valley is a relatively small organisation with a defined
geographical area which serves as a single unit of application. In the majority of
cases successful candidates will be asked to preference their choice of location for
either one or two years. Some programmes will require successful candidates to
indicate a location and specialty. Future placements will usually be based on
individual training and educational needs. Please note that applications are to the
Health Education Thames Valley as a whole. This may mean that you may be
allocated to any geographic location within the deanery depending on training
needs.
The Emergency Medicine Training Programme
The Emergency Medicine training programme is a 3 year programme, starting at
ST4. During this time, the trainee's work will be monitored for satisfactory progress
and subject to annual reviews in the form of ARCPs. Progression on the programme
will be dependent upon these reviews.
Out of Programme experience and training is encouraged; with several trainees
currently/recently on ICM dual training, PEM and PHEM dual training, educational
and leadership fellowships, expedition and wilderness medicine experience etc.
It is a small, close knit Deanery that aims to prepare trainees for life as a Consultant
in EM: most trainees take up Consultant posts in the region.
The posts on this rotation have been approved for Specialist Training by the College
of Emergency Medicine. The posts attract National Training Numbers and provide
training towards a Certificate of Completion of Training (CCT).
The Postgraduate Dean has confirmed that all posts have the necessary educational
and staffing approvals.
The programme is based in several different Trusts throughout Health Education
Thames Valley so trainees may find themselves employed by any of the following
Trusts and placed in any of the following hospitals:
Trust
Oxford University Hospitals
NHS Trust
Hospitals and Locations
John Radcliffe, Oxford
http://www.ouh.nhs.uk/
Milton Keynes Hospital NHS
Foundation Trust
Buckinghamshire
Healthcare NHS Trust
Milton Keynes General Hospital
http://www.mkgeneral.nhs.uk/
Stoke Mandeville, Aylesbury
http://www.buckshealthcare.nhs.uk/
Wycombe Hospital, High Wycombe
http://www.buckshealthcare.nhs.uk/
Royal Berkshire NHS
Foundation Trust
Royal Berkshire Hospital, Reading
http://www.royalberkshire.nhs.uk/
Heatherwood and Wexham
Park Hospitals NHS
Foundation Trust
Wexham Park Hospital, Slough
http://www.heatherwoodandwexham.nhs.uk/location/wexhampark-hospital-slough
Rotation Information
Rotations may at times change in response to clinical need from the Trusts.
Expected rotation arrangements for this programme are:

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All trainees rotate at yearly intervals in August.
All trainees rotate through Oxford for one year of their training, and spend the
other two years in two of the other hospitals.
Trainee preference and geographical location is taken into account wherever
possible in allocation of rotations.
Individual Trust Information
Oxford University Hospitals NHS Trust
General information
The Oxford University Hospitals NHS Trust is one of the largest acute teaching trusts
in the UK. We have a national and international reputation for the excellence of our
services and our role in teaching and research.
At the end of the financial year 2008/9 the Trust employed a total of 10,283 people
(equivalent to 8,052 full-time employees), making us one of the largest employers in
Oxfordshire, with a turnover of £614 million.
The Trust provides high quality general hospital services for the local population in
Oxfordshire and neighbouring counties, and more specialist services for patients
from a wide geographic area.
We have around 1,500 inpatient beds across our three sites. In 2009/10 there were:
123,592 attendances at the emergency departments, 87,275 admissions for
emergency assessment and treatment, 614,056 outpatient appointments, 19,688
admissions for treatment as inpatients, 62,062 admissions for treatment as day
cases (108,308 if renal dialysis is included) and 8,077 babies delivered.
The Trust is split across four large sites:
John Radcliffe Hospital, Churchill Hospital, Nuffield Orthopaedic Centre and Horton
General Hospital (Banbury)
As a teaching Trust, we have a vital role to play in the education and training of
doctors, nurses and other healthcare professionals. We do this in close partnership
with the Oxford University and Oxford Brookes University. The Trust is also involved
in a wide variety of research programmes, in collaboration with the University of
Oxford and many other research bodies.
The Emergency Departments
There are 2 Emergency Departments, one at the John Radcliffe, and one at the
Horton Hospital. The Emergency Medicine HST trainees all work at the John
Radcliffe site. The John Radcliffe became a Level 1 trauma centre in April 2011.
There is a full range of tertiary services at the John Radcliffe site.
The Emergency departments have 12 Consultants, 12 middle grades and 12 junior
grade doctors at the John Radcliffe, and 7 middle grades and 8 junior grade doctors
at the Horton. Further information can be found at: http://www.ouh.nhs.uk/
Local teaching
In addition to a 1-2 day induction, the teaching at the ORH for the EDs is as follows.
The local training at the John Radcliffe ED occurs on the second Wednesday of each
month, and lasts for a whole day; trauma meeting in the morning and clinical
governance in the afternoon. The teaching programme is currently concentrating on
critical appraisal skills, OSCE preparation and management teaching.
There are also dedicated sessions in Paediatric EM, and on the ECRU (prehospital
land vehicle), together with opportunites within helimed.
First tier teaching at the John Radcliffe occurs twice a month for a half day.
The first tier teaching at the Horton occurs on Friday mornings between 9am and 12.
It comprises teaching with Paediatrics in the ED, followed by sessions delivered by
Dr George (consultant), and ending with Radiology teaching. The weekly middle
grade teaching is on Thursday afternoons.
The Royal Berkshire NHS Foundation Trust
General information
The Royal Berkshire NHS trust is a foundation hospital and provides a wide range of
services for a population of about 600,000 people living in the west of Berkshire,
purchased mainly by the PCTs of West Berkshire. The area extends as far as
Hungerford in the west to Henley on Thames and Braknell in the east, parts of
Hampshire to the south and parts of Oxfordshire to the north.
Emergency Department
The department is the main ED in West Berkshire, serving a population of 600,000
and sees approximately 80,000 new patients a year about 25% of these being under
16 years old. It is a consultant led service with consultants providing leadership and
patient care on the ‘shop floor’ into the evenings 7 days a week.
On the RBH site there is also a dedicated ophthalmic casualty department, which is
open daily, there is also an out of hours GP cooperative with which we have
excellent relations. Within the region there is a WIC in Reading town centre and MIU
in Newbury and Henley.
The department has excellent links with inpatient hospital teams with two of the
recent consultant appointments being joint posts with the Intensive Care Unit. We
work collaboratively with other inpatient teams as demonstrated by our award of a
HSJ patient safety award for work on neutropenic sepsis and falling door to balloon
times for PCI. We are keen to promote further collaborative working and will shortly
be providing extended hours stroke thrombolysis led jointly by the neurology and
emergency medicine consultant teams.
The Emergency Department is a purpose built unit opened in 2002 comprising four
resuscitation bays (3 adult and 1 paediatric) equipped to provide state of the art care
to critically ill and injured patients. There are 12 majors’ assessment bays, a 3
bedded rapid assessment area and a dedicated minor area – with treatment bays
and a plaster room.
The new paediatric emergency department opened in 2010 has a dedicated waiting
room, 4 major assessment bays, minor injury assessment cubicles and 2 treatment
rooms.
In addition there are 4 observation beds for ED patients on the adjacent Clinical
Decision Unit, a decontamination unit within the ED, and two dedicated X-ray rooms.
The main radiology department with CT, US and MRI scanning facilities is directly
opposite the department.
The department has a computerised registration, tracking and clinical audit system
as well as a computerised radiology PACS system. We are currently developing and
implementing a purpose designed Electronic Patient Record system, which will
integrate many of these functions and provide seamless record keeping throughout
the trust. Phase one is due to be implemented in the spring of 2011.
These other services mean that we see a higher than average acuity of patient in the
ED and the vast majority of patients have genuine emergency medicine problems.
Our admission rate is approximately 20%. Over the last year we have introduced a
new Emergency Nurse Practitioner service. There is a consultant led ED review
clinic held every weekday morning.
Staffing of the Emergency Department
Consultants in Emergency Medicine
Dr Liza Keating (ICU / EM), Dr David
Mossop (EM / ICU) (Clinical Director), Dr Rob Slater, Dr Rob Tan, Dr Lisle Blom, Dr
Rosie Hancock, Miss Maria Dudek, Mr Sreenath Reddy, Dr A Hinterholzer, Dr Omar
Nafousi (PEM), Dr Manish Thakker, Dr Jane Brenchley
Associate Specialists
Dr P Jeyakumar
Dr B Sharma
Dr S Myint
Mr J Nagaraj
ST3 – ST6
Five – Oxford rotation
Speciality Doctors
Dr A Donohoe
Dr T Perry
Dr B Gerov
Dr V Dimitrov
Dr R Weldon (part time)
Dr A Sandercott (part time)
Junior doctors
1 ACCS ST1
5 GP VTS ST1
4 F2
Emergency Nurse Practitioners
7 WTE
Matrons
Brenda Morton
Georgina Brown
Teaching, Research and Audit
The department has an active and well-received educational programme.
We recently received a grade A from the Deanery Approval Committee for 2010 for
the Royal Berkshire Hospital NHS Trust for both Emergency Medicine and our ACCS
programme. For junior doctors a weekly programme based on the new CEM ACCS
curriculum has been developed which makes good use of the simulation centre.
There is a monthly middle grade educational after-noon, we regularly host regional
training days for ST3 and ST4 – 6 EM trainees which receive excellent feedback.
The trust regularly holds regular life support courses (including ATLS, ALS and
APLS).
The trust has an excellent reputation for education, as measured by its PMETB
report and regular responses from trainees and medical students. It has a recently
upgraded medical library and an active clinical librarian service, a clinical skills unit
and a state of the art simulation centre opened in 2009.
Wexham Park Hospital
The population & district
East Berkshire has a population of 380,000 and covers the Boroughs of Slough,
Windsor & Maidenhead, and Bracknell, but together with an overlap zone in South
Buckinghamshire, the true catchment area of the Trust is nearer to 430,000, of
whom 90 000 are children. This is a large and diverse population and includes
affluent areas such as Ascot, Windsor, Gerrards Cross and Maidenhead, but also
the larger urban area of Slough. The towns of Bracknell, Maidenhead, Slough and
Windsor house two-thirds of the total population, the remainder living in rural areas
or small towns. Much of the District lies within the designated Green Belt areas.
The Trust
The Trust is an Acute Hospital Trust and achieved Foundation status in 2007. It has
750 beds and provides in-patient services on two sites: Heatherwood in Ascot and
Wexham Park, north of Slough - essentially, one hospital on two sites. In addition,
the Trust provides outpatient and diagnostic facilities at St Mark’s Hospital
(Maidenhead), King Edward VII Hospital (Windsor) and Upton Hospital (Slough).
This post will work exclusively at Wexham Park Hospital.
The hospitals
Wexham Park Hospital, Slough, has 520 beds with a full range of services including
general medicine and its sub-specialities, paediatrics, general surgery, vascular
surgery, urology, orthopaedics, obstetrics and gynaecology, otolaryngology, oral
surgery, and also a sub-regional plastic surgery unit with an extensive catchment
area. There is an active programme of building and development. The Emergency
Department underwent a major rebuild and enlargement, with a self-contained
children’s area, in 2003, and is due to have further capital development in the next 23 years, to include an integrated Clinical Decision Unit and improved children’s
facilities.. There are well developed intensive care and cardiac investigation and
treatment units, with developing links with the ED. There is also an excellent new
rehabilitation department, a centralised laboratory, and diagnostic imaging including
a new spiral CT scanner and MRI. A new theatre complex opened in 2004 and a
surgical assessment unit.
There is a large purpose built post-graduate centre with skills lab, which runs regular
ATLS, ALS, and APLS courses. The extensive library has an intranet connection to
the wards for accessing guidelines, Medline etc.
Heatherwood Hospital, The minor injuries unit, which comes under the auspices of
the main ED, is staffed by Nurse Practitioners who care for 20,000 attendances per
year. The hospital in Ascot, has 230 beds including general medicine and its subspecialities, elective orthopaedics, urology, otolaryngology, oral and general surgery,
elective and emergency gynaecology and a midwifery-led low risk maternity unit plus
a children’s centre. A superb diagnostic imaging unit opened in August 1998.
The Emergency Department
The staff in the Emergency Department deliver care to in excess of 90 000 new
patients a year, with an additional 4000 returns. Approximately 25% of patients are
children and the overall admission rate is 21%. There are excellent facilities
comprising a five bedded resuscitation unit plus a well-resourced trauma bay
equipped with overhead X-ray gantry. There is an 8 bedded majors unit and a 6
bayed minors area plus dedicated ENT / Eyes and Gynaecology examination
cubicles. Children are cared for in a separate unit, which is open for between 12-14
hours a day and contains a waiting area (often supervised by Play Specialist), triage
room, teenage room, treatment room and three bays. Each area of the department
has a bay, which has additional resources to meet the needs of children attending
when the Paediatric unit is not open. A four bedded observation facility is within the
department and patients are admitted there under the care of the Emergency
Physicians for periods of up to 12 hours.
At Heatherwood Hospital there is a Minor Injuries Unit, which sees approximately
24,000 – attendances a year. One consultant undertakes review clinic at
Heatherwood on a weekly basis. There is also a Walk In Centre at Upton Hospital,
Slough and discussions are underway regarding provision of primary care
practitioners at Wexham Park site. The new MIU at St Marks opened in September
2008.
The current establishment includes 6 Consultants, 1 Associate specialist, 2.5 Staff
Grades, 2 Senior Clinical fellows and 9 ST3 - 6 / SpRs, (who are part of the Oxford
Regional Training Programme). The junior tier consists of 5VTS, 4 FY2, 1 ACCS and
4 junior clinical fellows. The nursing establishment is overseen by a modern matron
supported by a team of senior nurses and a Practice Development Nurse. Much of
the care of patients presenting with minor injuries is delivered by Emergency Nurse
Practitioners, who contribute to the training of junior doctors and nursing colleagues.
The Paediatric area is run by a band 7 RSCN, and there is a commitment to having
either a fully trained paediatric nurse, or one with agreed competencies, on every
shift.
Support Services
At Wexham Park there is a full and comprehensive Pathology, Diagnostic Imaging
(including CT and MRI), Diagnostic Cardiology and Endoscopy Service. At
Heatherwood Hospital there are routine Pathology Services 9.00am – 5.00pm,
Diagnostic Imaging, Diagnostic Cardiology & Endoscopy with plans for continued redevelopment and upgrading of these services. The Trust opened an MRI Suite on
the Wexham Park site in 2004.
Buckinghamshire Healthcare NHS Trust
General Information
Buckinghamshire NHS Trust, the major acute provider for Buckinghamshire County,
has around 780 beds across three sites in Amersham, Wycombe and Stoke
Mandeville. About 4,500 people are employed.
As well as services to local people, such as accident and emergency services, and
all branches of surgery and medicine, the Trust has specialist services including
burns and plastic surgery, dermatology and accredited centres for urology and skin
cancer.
Alongside these services the Trust provides the internationally acclaimed National
Spinal Injuries Centre at Stoke Mandeville offering care to adults and children with
acute spinal cord injury and life-long complications of cord injury.
The current configuration of the clinical services reflects changes that have been
made in order to focus specialist expertise from across the Trust into single in-patient
units. This has allowed for more comprehensive sub speciality cover, development of
expertise and better multidisciplinary working whilst retaining local access for the
majority of acute care and hospital visits. As a result of a visit by Lord Darzi the Trust
development of its philosophy of “localise if possible, centralise only where clinical
necessary” was central to the reconfiguration proposals. Subsequent changes have
allowed the Trust to meet the national strategic direction within the Next Step Review
without need for further major services reconfiguration.
The Trust’s service configuration affords highly integrated team-working across sites
with specialist inpatient care provided from centralised inpatient units. These units
are distributed across the Trust reflecting the need to serve the two major
Buckinghamshire population centres of Wycombe and Aylesbury. Women and
Children’s care was realigned to this model by the end of 2009 and new facilities
have been provided at the Stoke Mandeville hospital.
Our hospitals each have lead roles alongside the provision of general acute care:
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Stoke Mandeville Hospital has a lead role in providing emergency and
specialist surgery including trauma, general surgery, ophthalmology, burns,
plastics and the National Spinal Injuries Centre.
Wycombe Hospital is the centre for elective surgery as well as providing an
Emergency Medical Centre and specialist inpatient medical services
including: cardiology, respiratory medicine and haematology units
Amersham Hospital provides inpatient rehabilitation and specialist
dermatology services
All three hospitals provide a wide range of ambulatory care, clinic and
diagnostic services.
Information on Emergency Departments
The Emergency Department at Stoke Mandeville cares for about 53,000 patients
annually of which about 50,000 are new and include GP referrals. There are four
resuscitation bays and eleven ‘major’ cubicles. A separate Minor Injuries Unit has
been created adjacent to the Majors area. The Minor Injuries Unit comprises a subwaiting area, 3 assessment/treatment rooms, a Doctors’/Nurses’ work area, and a
dedicated eye room equipped with a slit lamp. The Minor Injuries Unit is staffed by
Emergency Nurse Practitioners covering up to 12 hours a day, seven days a week,
and their work is complemented by Emergency Department doctors. There is also a
purpose-built Paediatric Decisions Unit which caters for children presenting through
the Emergency Department and for children referred by GPs. A six bedded
Observation ward completes the existing Emergency Department.
An integrated front door bringing together in a collaborative manner primary care and
the Emergency Department is scheduled for the latter part of 2010. This will expand
the existing area by a further 3 clinical rooms. Further development of the
department is scheduled for 2011 with plans to extend the resuscitation room,
current major’s area, and current x-ray area. Additionally a Clinical Decisions Unit
will be provided.
The Emergency Department at Stoke Mandeville Hospital is a designated major
incident unit. Major trauma is attended by the trauma team which is complemented
by the Emergency Department Consultants as required.
The Emergency Medical Centre at Wycombe cares for about 48,000 patients
annually of which about 45,000 are new and include GP referrals. There are four
resuscitation bays, nine ‘major’ cubicles, dedicated paediatric assessment and a
minor injuries unit with seven cubicles, including eye examination facilities. The
Minor Injuries service is currently staffed by Nurse Practitioners covering up to 12
hours a day, seven days a week, and their work is complemented by Emergency
Department doctors. There is also a three-bedded observation bay.
Both Emergency Departments within Buckinghamshire Hospitals NHS Trust have a
digital imaging system which can be accessed from either site enabling efficiency of
patient care.
In addition, there is a newly purchased portable ultrasound scanner in the
Emergency Department at Stoke Mandeville.
Following reconfiguration of health services in 2005, emergency surgery and trauma
were consolidated on the Stoke Mandeville site whilst acute medicine, cardiology
and respiratory services are based at Wycombe. Stoke Mandeville Hospital retains
all acute services. Women’s and Children’s services have been centralised at the
Stoke Mandeville site since October 2009.
Consultants:
Dr S McMorran (Service Delivery Unit Director), Mr G Thirumamanivannan, Mr D
Potts, Mr A Oludemi, and Dr A Alani.
Middle Grade Tier (rotating):
Registrars (SpR, ST3 and above)
Specialty Doctors
Associate Specialist
1
4
11
Junior Tier (rotating):
F2, CT1, CT2, ACCS & VTS
16
Service Manager:
Mary Frewer
Lead Nurse:
Esa Rintakorpi
Higher Training in Emergency Medicine
Currently four higher trainees (SpR, ST3 and above) are placed at Stoke Mandeville
Hospital as part of Oxford rotation. Secondment to other specialties or the
Emergency Medical Centre at Wycombe can be arranged as required to meet the
training requirements.
The trainees are on an attractive Working Time Compliant rota of 48 hours per week.
They work one in seven weeks of night shifts, Monday to Thursday, and two
weekends in seven weeks (one 0800-1800 and the other 1200-2200). During
weekdays the rota allows for the trainees to attend the Regional Training Days on
alternative Tuesdays. They also get a CPD day in the weeks with no training day.
The trainees will be expected to become involved in various clinical governance
activities, in addition to their service commitments from leading the team in resus to
providing support for minor injuries.
Teaching and Training
All the trainees have a designated Educational Supervisor and receive mentoring
and pastoral care from the consultants. In addition to the Regional Training Days
Middle Grade teaching is provided on the last Thursday of each month from 14001700. Trainees are actively encouraged to participate in both the Middle Grade and
first tier teaching programmes, including induction training. Ample opportunities are
available to become involved in postgraduate medical education, such as teaching
on resus courses, the ALERT course, and various Trust-level multi-disciplinary
teaching sessions. A Sim-Man is available at the postgraduate centre.
Necessary support will be provided for audit and research activities both from the
Emergency Department and our friendly Clinical Audit and Effectiveness
Department.
Milton Keynes Hospital NHS Foundation Trust
General information
Milton Keynes Hospital Foundation Trust provides a comprehensive range of
services to the local population. The vast majority of our activity comes from the
immediate local area of Milton Keynes and our vision as an organisation is to be the
health care provider of choice.
Milton Keynes Hospital has come a long way in a short amount of time. We are a
relatively new hospital, opened in 1984 following a successful campaign by local
people to secure a hospital for Milton Keynes which had been established as a new
town. Since then, the town has continued to grow at a rapid pace. Our local
catchment population now stands at 267,000 and is forecasted to grow to 412,000
by 2031. A key part of our service strategy therefore is to grow our services in
response to the population growth in order that we can best meet the needs of the
local community. Although our strategy is to grow services, we intend to remain a
general provider of services rather than become a tertiary provider.
Milton Keynes is a rapidly developing, dynamic and unique city situated on the
doorstep of beautiful Buckinghamshire countryside. It lies mid-way between
Northampton and Aylesbury and is traversed by the M1. It is on the West Coast Main
Line (fast train to Euston currently 35 minutes) and (for those in less of a hurry) the
Grand Union Canal. The city lies in attractive countryside, with a wide variety of
housing both new and old in the city and in the surrounding small villages.
Milton Keynes is not only famous for its concrete cows but also for its first class
facilities. Shopping is provided by “The Centre MK”, a well-known large and
comprehensive modern retail development, as well as a plethora of specialist
retailers in the older parts of the city and three large out-of-town developments.
Sporting facilities are exceptional. There are leisure centres, a David Lloyd Racquet
and Fitness Centre, a large water sports facility and the longest real snow indoor ski
slope in Europe. The National Centres for Hockey and Badminton are sited in Milton
Keynes and there is a major equestrian centre in Hanslope. There are public and
private golf courses to suit all abilities. Sport is angled more at participation but for
those who prefer to watch, the MK Dons provide league football.
Milton Keynes is home to an excellent theatre, part of the Ambassador group which
guarantees a consistently high standard of production. It is the best attended
regional theatre in the country. The MK Bowl is both famous and notorious as a pop
venue. There are two multiplex cinemas and numerous restaurants cafes and bars.
Emergency Department Staff
Consultants
Mr Peter Thomas
Mr Richard Ajuwon
Mr Ikenna Ezeilo
Mr Riaz Khan
Dr Vimal Desai
Interests
Associate Medical Director (Education)
Head Oxford School of Emergency Medicine.
Clinical Director, Emergency Planning and Emergency ultrasound
Information Technology & Primary care
Clinical Governance and Paediatrics
Medical education
Grade
Number
Specialty Doctors
Specialist Registrars
Trust Doctors
FY2/GPVTS/ACCS
3
4.7 WTE
3
8
Modern Matron: Julie Orr
The Emergency Department is a purpose-built modern unit commissioned in 1984.
The accommodation and facilities are constantly upgraded to deal efficiently 24
hours a day with major and minor medical, surgical, orthopaedic, paediatrics,
obstetrics, and gynaecology and trauma emergencies. The department has recently
been refurbished to facilitate the increasing demand for the service. The Department
currently sees 69,000 new patients per year. Approximately 30% of these are
children. It is the only Emergency Department for the Milton Keynes district and
currently serves a population of 250,000. It is a designated major incident centre.
Follow-up clinics are conducted in the Department by the Emergency Department
consultants for continuing treatment of minor conditions.
a]
The reception area is staffed 24 hours a day by two receptionists. The ED
records are computerised. The computer works on an integrated system –
ED being part of CRS.
b]
Waiting Area – there are separate children and adult waiting areas. The
ambulance patients are brought in through a separate entrance. Initial
assessment is performed in a designated room
c]
There are nine multipurpose major examination and treatment cubicles, of
which one is adopted and equipped for obstetric and gynaecology patients.
d]
Fully equipped resuscitation room with 5 bays, one of which is equipped
primarily to resuscitate children and one equipped to receive major trauma.
There is an overhead X-ray facility, a blood gas machine and portable
ultrasound machine.
e]
In 2000 a new purpose built paediatric area for patients attending Emergency
Department was completed.
The area incorporates waiting area,
treatment/isolation rooms and 3 separate cubicles.
f]
An ED observation ward, equipped with 7 trolley beds, piped gases and
suction.
g]
A Departmental seminar room with usual audio-visual teaching aids, boards
and a small library exists.
h]
A well-furbished room with its own TV, fridge and other amenities for
distressed relatives/viewing.
i]
Plaster room. Trained nurses and health care assistants provide a plastering
service.
j]
A dedicated treatment room
k]
Seven examination and treatment bays for the walking wounded which like all
clinical areas, have piped gases and suction. Two clinic rooms, a “see &
treat” room and a triage room
l]
Eye/ENT and dental room - which is equipped with slit lamp, magnifying lamp
and various other diagnostic tools.
m]
There are Minor Trauma and Review Clinics [MTRC] three times a week, a
weekday ED eye review clinic and a weekly hand clinic. Extensive
physiotherapy and hand therapy facilities are easily accessible to the ED
patients. A trained Hand Therapist assists in the Hand Trauma Clinic.
n]
Emergency Nurse Practitioner’s room.
o]
Office accommodation for doctors, nurses and secretaries.
p]
A staff common room equipped with TV, microwave and other amenities is
shared by all ED staff.
q]
A helipad is located just across the car park near the Department.
r]
A dedicated car park bay for disabled drivers and short stay wait of 30
minutes is reserved for free use by ED patients just outside the department.
The rest of the car parks operate a pay and display system.
s]
There is an Emergency Department satellite X-ray Unit which operates a
PACS system. There are 24-hour CT scan facilities available from a wellequipped Radiology Department. The scan can be transmitted to the
Regional Neurosurgical Unit, which is at Oxford.
t]
Ophthalmic, Plastic and Burns in-patients facilities are provided in the
neighbouring Stoke Mandeville Hospital. Maxillo-facial services are provided
during weekdays on site, and out of hours at Luton and Dunstable Hospital.
u]
ITU and Phase I Operating Theatres are situated directly above the
department and are easily accessible.
v]
CCU and Clinical decision Unit are situated on the ground floor.
w]
There is a sub-pharmacy within the department which houses most of the
commonly used drugs for after-hours dispensing. A very prompt service from
a fully trained Pharmacist is available during normal working hours and a
Pharmacist is on-call if necessary.
x]
Community liaison with Paediatric and Geriatric Health Visitors exists. The
liaison Health Visitor and District Nurse visit the department on a daily basis
accepting referrals and relaying information to Health Visitors, School Nurses,
Community Paediatric sectors for children 0-16 years and another Community
Liaison for patients aged 65 years and over. A Community Psychiatric Nurse
is available in the Department between 5pm and 1 am. The Emergency
Department has an Occupational Therapist whose key role is in facilitating
patients’ discharge.
y]
There is a small departmental library with some useful books and extensive
library facilities in the postgraduate centre.
Teaching
The weekly middle grade teaching is attended by all consultants. Trainees are
released for regional training days.
There is an active Postgraduate Education Centre, which houses the hospital library.
There is a programme of clinical meetings and lectures. The medical library is jointly
funded and has regular supplies of most general medical journals. It has a good
selection of books and CD ROM facilities are available on site. There are also on-line
search facilities. The Associate Medical Director (Education), Mr Pete Thomas is
responsible for organising the programme, and active participation of Consultants,
Trainees and General Practitioners is strongly encouraged. There is an active
Speciality Tutors Committee that meets regularly.
There is a newly built simulation centre.
Regional Teaching


There is a regional training programme for trainees, which runs on 2 days per
month, with the location of the day rotating around the region.
Trainees are expected to attend the training days, with the exception of when
they are on night shifts.

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The programme is coordinated by one of the trainees, with regular input into
the training days from the local consultants.
Training is aimed towards successful completion of the FCEM examination as
well as general continuing professional development needs.
In addition, each hospital has its own programme of in-house middle grade
teaching.
Further information can be found on the trainee website www.oxem.org.uk
Duties of the Posts
To receive, initially assess, diagnose and treat all categories of accident &
emergencies that may attend the departments. To arrange for the appropriate
transfer of patients to in-patient facilities, outpatient referral or discharge to primary
care as indicated.
The trainee is required to participate in audit, clinical governance activities, teaching
and appraisal.
The trainee has a responsibility for the training and supervision of more junior
medical staff, medical students and other professional staff who work with them.
All medical and dental staff employed by the Trusts are expected to comply with
hospital & deanery health and safety policies, Clinical Governance and other risk
management policies.
Main Conditions of Service
Appointments to this programme are subject to the Terms and Conditions of Service
(TCS) for Hospital Medical and Dental Staff (England and Wales). In addition
appointments are subject to:
 Applicants having the right to work and be a doctor or dentist in training in the
UK
 Registration with the General Medical Council
 Pre-employment checks carried out by the Trust HR department in line with
the NHS employment check standards, including CRB checks and
occupational health clearance.
The employing Trust’s offer of employment is expected to be on the following
nationally agreed terms:
Hours – The working hours for junior doctors in training are now 48-hours (or 52hours if working on a derogated rota) averaged over 26 weeks (six months). Doctors
in training also have an individual right to opt-out if they choose to do so, but they
cannot opt-out of rest break or leave requirements. However, the contracts for
doctors in training make clear that overall hours must not exceed 56 hours in a
week (New Deal Contract requirements) across all their employments and any
locum work they do.
http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/EWT
D/Pages/EWTD.aspx
Pay – you should be paid monthly at the rates set out in the national terms and
conditions of service for hospital medical and dental staff and doctors in public health
medicine and the community health service (England and Wales), “the TCS”, as
amended from time to time. The payscales are reviewed annually. Current rates of
pay may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircular
sMedicalandDental.aspx Part time posts will be paid pro-rata
Pay supplement –depending upon the working pattern and hours of duty you are
contracted to undertake by the employer you should be paid a monthly additional
pay supplement at the rates set out in paragraph 22 of the TCS. The current
payscales may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircular
sMedicalandDental.aspx . The pay supplement is not reckonable for NHS pension
purposes. The pay supplement will be determined by the employer and should be
made clear in their offer of employment and subject to monitoring.
Pension – you will be entitled to join or continue as a member of the NHS Pension
Scheme, subject to its terms and rules, which may be amended from time to time. If
you leave the programme for out of programme experience you may have a gap in
your pension contributions. More information can be found at
http://www.nhsbsa.nhs.uk/pensions
Annual Leave – your entitlement to annual leave will be five or six weeks per annum
depending on your previous service/incremental point, as set out in paragraphs 205206 of the TCS. The TCS may be viewed at
http://www.nhsemployers.org/PayAndContracts/MedicalandDentalContracts/JuniorD
octorsDentistsGPReg/Pages/DoctorsInTrainingJuniorDoctorsTermsAndConditions150908.aspx
Sick pay – entitlements are outlined in paragraph 225 of the TCS.
Notice –you will be required to give your employer and entitled to receive from them
notice in accordance with paragraphs 195-196 of the TCS.
Study Leave –the employer is expected to offer study leave in accordance with
paragraphs 250-254 of the TCS. Local policy and procedure will be explained at
induction.
Travel Expenses – the employer is expected to offer travel expenses in accordance
with paragraphs 277-308 of the TCS for journeys incurred in performing your duties.
Local policy and procedure should be explained at induction.
Subsistence expenses – the employer is expected to offer subsistence expenses in
accordance with paragraph 311 of the TCS. Local policy and procedure should be
explained at induction.
Relocation expenses – the employer will have a local policy for relocation expenses
based on paragraphs 314 – 315 of the TCS and national guidance at
http://www.nhsemployers.org/PayAndContracts/MedicalandDentalContracts/JuniorD
octorsDentistsGPReg/Pages/DoctorsInTrainingJuniorDoctorsTermsAndConditions150908.aspx
You are advised to check eligibility and confirm any entitlement with the employer
before incurring any expenditure.
Pre-employment checks – all NHS employers are required to undertake preemployment checks. The employer will confirm their local arrangements, which are
expected to be in line with national guidance at
http://www.nhsemployers.org/RecruitmentAndRetention/Employmentchecks/Pages/Employment-checks.aspx
Professional registration – it will be a requirement of employment that you have
professional registration with the GMC/GDC for the duration of your employment.
Though the post is covered by NHS Indemnity, you are strongly advised to register
with the MPS for professional indemnity.
Health and Safety – all employers have a duty to protect their workers from harm.
You should be advised by the employer of local policies and procedures intended to
protect your health and safety and expected to comply with these.
Disciplinary and grievance procedures – the employer will have local policies and
procedures for dealing with any disciplinary concerns or grievances you may have.
They should advise you how to access these, not later than eight weeks after
commencement of employment.
Educational Supervisor – the employer or a nominated deputy (usually the Director
of Medical Education) will confirm your supervisor on commencement.
General information on the LETB’s management of Specialty Training
programmes, including issues such as taking time out of programme and dealing
with concerns or complaints, is available at www.oxforddeanery.nhs.uk and in the
national ‘Gold guide’ to Specialty Training at http://specialtytraining.hee.nhs.uk/.
Please ensure that you inform Health Education Thames Valley of any changes to
your contact details.
January 2014